Archive for March 2010

Utopian College of Emergency for Medicine announces founding of “The Poison Preview”

March 31, 2010, 9:14 pm

Having just returned from the American Institute of Ultrasound in Medicine meeting in San Diego, I have not yet had a chance to note that several days ago the eminent Egerton Y. Davis IV announced in the Welsh town of Llanfairpwllgwyngyllgogerychwyrndrobwllllantysiliogogogoch that UCEM is set to begin publication of “The Poison Preview”. This journal will be dedicated to the …

Read More »

Rating revision: Did I say 3-1/2 skulls? Make that 2.

March 31, 2010, 6:03 pm


Hydroxocobalamin and Sodium Thiosulfate Versus Sodium Nitrite and Sodium Thiosulfate in the Treatment of Acute Cyanide Toxicity in a Swine (Sus Scrofa) Model.  Bebarta VS et al.  Ann Emerg Med April 2010;55:345-351.

When this article was posted online back in December, I reviewed it and gave it three-and-a-half skulls.  Now that it is available in print, I’ve …

Read More »

Tox Tunes #13 – Amphetamine Annie (Canned Heat)

March 29, 2010, 11:37 am

The blues-rock band Canned Heat took their name from Tommy Johnson’s 1928 classic “Canned Heat Blues“.  “Amphetamine Annie” — with its repeated admonition “Speed kills!” —  was probably the best-known anti-drug song of the 1960s.…

Read More »

Dialyzing the Toxicology Patient

March 29, 2010, 11:17 am


Dialysis in the poisoned patient.  Bayliss G.  Hemodialysis Int  2010 March 19 [Epub ahead of print]


This is a helpful revieew of enhanced elimination techniques available for the management of toxicology patients.  Some key points emphasized in the article:

• Intermittent hemodialysis is ideal for low-molecular-weight, water-soluble toxins with small volumes of distribution and minimal binding to proteins or …

Read More »

Metformin and Creatine and Metabolic Acidosis: Really?

March 26, 2010, 2:12 pm


Severe metabolic acidosis secondary to coadministration creatine and metformin, a case report.  Saidi H, Mani M.  Am J Emerg Med  (2010) 28:388.e5-e6


This case report from Tehran describes a 42-year-old body builder who developed anion-gap metabolic acidosis (pH 7.25, anion gap 22 mEq/L) after taking a combination of metformin and creatine for 3 weeks. He presented with anuria (creatinine …

Read More »

Drug-Induced Lactic Acidosis: Case Report and Review

March 25, 2010, 12:03 pm

BMJ  online has a nice brief case report and review of life-threatening metformin-induced lactic acidosis (MALA). Some key points:

• Although deliberate acute metformin overdose generally has a good prognosis, inadvertent chronic metformin toxicity is extremely serious and still has a mortality rate of about 50%.

• Precisely identifying the diagnosis and be difficult early on, since alternative considerations such …

Read More »

Medical Publishing in the Age of Web 2.0

March 24, 2010, 12:11 am

In a must-read post on the British Medical Journal (BMJ) blog site, Richard Smith argues that the traditional peer-review system as a means to filter medical literature before publication is “slow, expensive, largely a lottery, poor at detecting errors and fraud, anti-innovatory, biased, and prone to abuse”.  He suggests moving from a model of “filter, then publish” to one of …

Read More »

Tox Tunes #12 – Canned Heat Blues (Tommy Johnson)

March 22, 2010, 12:47 am

Tommy Johnson — along with Son House and Charley Patton — was one of the key figures in the development of early Delta blues.  According to Robert Palmer’s indispensable book Deep Blues, Johnson (1896-1956) played guitar with “a slippery, danceable swing that derived from his superbly controlled mixing of duple- and triple-meter picking and strumming patterns, and his voice …

Read More »

More on Mephedrone (Meow-Meow)

March 21, 2010, 3:57 pm

The Guardian (U.K.) today has a piece “In Focus: Mephedrone” in which they talk to four people: a user, a mother, a dealer, and a doctor.  Unfortunately, despite its title, the piece is so unfocused that I really didn’t learn anything from it. Who exactly are these people.  Is “Jack Starks” — the user — his real name?  …

Read More »